From:  Edward L. Moreno, MD, MPH                                                                        Kristy Michie, MS

            Health Officer    831-755-4585                                                                       Epidemiologist       831-755-4503

 

Bites from Wildlife and Certain Domestic Animals Pose Risk for Rabies

Health care providers are urged to conduct a complete risk assessment and administer rabies post-exposure prophylaxis, if warranted, utilizing ACIP guidelines.

There has been some recent confusion expressed by providers related to the incidence of rabies in domestic animals in Monterey County.  Rabies is enzootic in Monterey County, particularly among skunks and bats.  While the canine variant of rabies is not found in California, all domestic animals in Monterey County including dogs and cats are at risk of infection with skunk and bat variants of rabies.  Over the last few years there has been an increase in rabies among domestic animals in Monterey County.  On July 2, 2015, a cat owned by an individual who resides within the City of Monterey tested positive for a bat variant of rabies.  In 2012, a dog from the North Monterey County area was infected with a skunk variant of rabies.  The dog had received at least one dose of rabies vaccine.  At this time, the Health Department recommends health care providers in attendance of patients with animal bites: 

1. Clean the wound with soap and water or a virucidal agent.
2. Evaluate the risk of rabies virus exposure.  Assessment should be based on the number, severity, and location of bites; the biting animal’s species; the biting animal’s behavior and potential for contact with wildlife; and the disposition of the biting animal. 
3. When risk assessment warrants, provide appropriate rabies post-exposure prophylaxis (PEP) following Advisory Committee on Immunization Practices’ (ACIP) guidelines available at https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5902a1.htm.  All previously unvaccinated adults, children, and infants should receive human rabies immune globulin (HRIG) with their first dose of rabies vaccine.
4. Promptly report animal bites to Monterey County Animal Services (phone: 831-769-8850).  A blank reporting form is available at https://www.co.monterey.ca.us/government/departments-a-h/health/monterey-county-animal-services/get-help/animal-bites-rabies.   

More detailed guidance documents for rabies risk assessment and PEP administration are located at www.mtyhd.org/rabies.  If you have additional questions or concerns, please call the Monterey County Health Department’s Epidemiology & Surveillance Unit at 831-755-4698 or refer to the Centers for Disease Control and Prevention’s website (http://www.cdc.gov/rabies/) and the California Department of Public Health’s Investigation, Management, and Prevention of Animal Bites in California available at: https://archive.cdph.ca.gov/HealthInfo/discond/Documents/InvestigationManagementandPreventionofAnimalBitesinCA2014.pdf.  

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